Promoting Client Participation and Constructing Decisions in Mental Health Rehabilitation Meetings

  • Melisa StevanovicEmail author
  • Taina Valkeapää
  • Elina Weiste
  • Camilla Lindholm
Part of the The Language of Mental Health book series (TLMH)


The chapter analyzes practices by which support workers promote client participation in mental health rehabilitation meetings at the Clubhouse. While promoting client participation, the support workers also need to ascertain that at least some decisions get constructed during the meetings. This combination of goals—promoting participation and constructing decisions—leads to a series of dilemmatic practices, the dynamics of which the chapter focuses on analyzing. The support workers may treat clients’ turns retrospectively as proposals, even if the status of these turns as such is ambiguous. In the face of a lack of recipient uptake, the support workers may remind the clients about their epistemic access to the content of the proposal or pursue their agreement or commitment to the idea. These practices involve the support workers carrying primary responsibility over the unfolding of interaction, which is argued to compromise the jointness of the decision-making outcome.


Participation Proposals Joint decision-making Mental health rehabilitation Conversation analysis Access Agreement Commitment 



This study (and the studies reported in Chapters  6,  8,  9, and  12) was funded by the Academy of Finland (Grant No. 307630) and the University of Helsinki.


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Copyright information

© The Author(s) 2020

Authors and Affiliations

  • Melisa Stevanovic
    • 1
    Email author
  • Taina Valkeapää
    • 1
  • Elina Weiste
    • 2
  • Camilla Lindholm
    • 3
  1. 1.University of HelsinkiHelsinkiFinland
  2. 2.Finnish Institute of Occupational HealthHelsinkiFinland
  3. 3.Tampere UniversityTampereFinland

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